NIH's Fauci on coronavirus: 'The risk group is very, very clear'

As clinicians gear up to fight the novel coronavirus spreading throughout the U.S., top officials say they should focus special attention on seniors. (National Institute of Allergy and Infectious Diseases)

As clinicians gear up to fight the novel coronavirus spreading throughout the U.S., top officials say they should focus special attention on seniors.

"It’s so clear that the overwhelming weight of serious disease and mortality is on those who are elderly and those with a serious comorbidity: heart disease, chronic lung disease, diabetes, obesity, respiratory difficulties," said Anthony Fauci, M.D., director of the National Institutes of Health's National Institute of Allergy and Infectious Diseases.

"There will be outliers, as we’ve seen with influenza, [a person] who is young and healthy who winds up getting COVID-19, [gets] seriously ill and dies," Fauci said in a taped interview with Howard Bauchner, M.D., editor of the Journal of the American Medical Association. "But if you look at the weight of the data the risk group is very, very clear."

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It was just one of the observations he shared about COVID-19 which has been grabbing headlines, but for which there is limited information when it comes to treatment.

Here's what else Fauci had to say about COVID-19:

On testing capacity in the U.S.:
"There were clearly some missteps ... The goal over the next week to do is to rev it up so you could have at least a million-plus tests available for deployment within the next week to two. Hopefully, that eventuates into a reality, not just a goal. Then after that, when you get online, some of the very good companies that know what they’re doing [are] making a diagnostic test. Then I think the flow of those tests will be really smooth. Unfortunately, today we’re not there yet."

On the quality of the COVID-19 tests:
“They’re good. They’re standard [polymerase chain reaction] tests, and, if you do a PCR test right, it’s highly specific. Obviously, there are confirmation tests you want to do if you get just one because there can be contaminations with PCR. But they’re very sensitive down to a few copies much like some of the tests we have for HIV where we can get down to a few copies. If it’s positive, you absolutely can make a [clinical] decision. If it’s negative, you may be early on in the infection and the viral load may be so low, you don’t get it. That’s more of a concentration issue."

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On the actual case fatality rate:
"There's the number of cases that have come to the attention of healthcare providers. As of [Friday] morning, that’s like 98,000. Then on the other side, you have the number of documented deaths. That’s now like 3,700, 3,800. When you do that pure simple math, the deaths are the numerator, the cases are the denominator, that’s where you get the report from WHO that it’s somewhere between a 2% and 3% case fatality rate. However, when people do modeling … you have various assumptions that there are this many asymptomatic cases that never get counted. When you do that, you get a range of case fatality rates that always less than the actual numerical one because it always factors in relative proportions of asymptomatic ones that we don’t count."

On where studies are focusing for potential therapies:
"There are a couple of randomized controlled trials: A couple in China and one that we’re doing here in the United States ... because we have a continuing number of increasing people who are infected to test the drug such as remdesivir (using a standard of care versus standard of care with remdesivir). Hopefully in the next few months, if we have enough ... The Chinese are already a couple hundred into their clinical trial, that when the DSMV looks at the data, we’ll know whether it works or not. If it does, that would be wonderful and we’ll start distributing the drug. If it doesn’t, we’ll have to go toward other avenues."

On the lack of disease among children:
"What I still don’t totally understand is the lack of detectable infections in children, as well as the lack of serious disease. In one of the reports, there wasn’t a single identified case in someone younger than 15 which seems almost unbelievable. They have to be getting infected. Why they’re not developing clinical disease is really interesting. This is something we really need to study because it certainly will tell us something about what a correlative immune protection is."

On how we protect the elderly:
"Even if you’re not in the area with ongoing community spread, you’d do mitigation for everyone. Whether they’re elderly, immunocompromised or young, common sense should prevail.

The way we protect them in general is: Don’t take any unnecessary risks with them. If you have someone in their 70s, 80s or beyond, and even if they’re relatively healthy, do you really want to get on a plane and fly to wherever unless you have to? You have to treat the elderly and those with underlying conditions to protect them because they are vulnerable."

Check out what else he had to say below.